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About Us

As an owner and operator of multiple residential assisted living facilities for over 12 years, I felt alone and not supported. It is not easy to accomplish all my goals as an owner and operator. I have been in search for an organization or association that will give the support I needed. Instead, I regularly receive in the mail organizations asking me to send them a check to be a member and when I asked what my membership includes, it will give me some support but not the support I much needed. For example, there is a group that for $199, I will get the 40 hours training I need to renew my administrator certificate. But recently, I was notified that it is no longer included and CEU’s are now at additional cost.

Another organization promised for $350 they will provide updates for Title 22 regulations. I can call for general questions regarding Title 22. But that’s it. Then when I asked for the background of these organizations/associations, none of them owned or operated a residential assisted living facility. Some of them received a business or geriatric degree in college, some worked in skilled nursing facilities, and some are social worker, which are all important, but NEVER owned or operated a residential assisted living facility business. This made me think that the main problem is that none of these organizations or associations understands what we really need to be a better, smarter and innovative business owner, licensee and administrator of this generation.

But through my dedication and passion, I slowly began to make ways on how to gain support from different people in the industry. I used my experiences as my motivation to continue what I have started. In late 2015, I established California Board and Care Association which is now known as Residential Assisted Living Association.

Currently, there are over 6000 residential assisted living facilities smaller than 25-beds in California. Each of those 6000 facilities works independently. Instead of working together, we often treat each other as competitors. We believe that we are strong if we are united. This is the best way for us to help individuals get discounted and premium services that they really need which are currently only provided to large assisted living communities. As a group, we can change the future of residential assisted living communities.

Mylene Lee

Board Member

Mission Statement

To provide advocacy and a “united” focus for the improvement of Residential Assisted Living Facilities throughout the United States. To provide support, training, technology and quality advancements with a coordinated approach, providing resources and reduced costs through economies of scale.

[This is the first of a two-part series describing a new association in California for small Board and Care owner-operators.]

In the early 1990s when California first required educational certification for assisted living administrators, groups seeking to train and represent them popped up and disappeared regularly. After about a decade, this activity stabilized and essentially stopped. But this year, a new California senior living association has been launched.

California Board and Care Association

Called the California Board and Care Association (CBCA), its aim is to improve and support the redheaded stepchildren of senior living – small, typically 6-bed, personal care homes. Officially designated in California as Residential Care Facilities for the Elderly (RCFEs), they are also called adult family homes, board and care, residential care, and personal care homes.

And while many people think “board and care” and “assisted living” are two separate levels of care, in actuality, they are more brother and sister than unrelated families. “We have a lot of work to do to raise awareness about board and care,” says Mylene Lee, President of CBCA. “The general public and, even many senior care professionals, don’t know much about who we are, what we do, or how we do it.

Assisted Living vs. Board and Care Homes

As in many other states, California’s assisted living (AL) communities and board and care (BC) homes are licensed and governed by the same state laws and regulations. They both serve seniors age 60+ and are non-medical facilities so they are not required to have nurses, certified nursing assistants or doctors on staff.

Communities referred to as “Assisted Living” usually have 50+ residents who live in private apartments with private bathrooms. Board and Care is typically a 3+-bedroom home with space for group activities and dining. Residents may have their own room, but often share a room and a bathroom.

AL and BC both serve seniors who prefer not to live alone or whose families prefer it. Both types provide the same basic services – rooms; meals; housekeeping; leisure activities; supervision, storage and distribution of medication; and assistance with activities of daily living, like dressing, bathing, hygiene, eating, and mobility.

The Statistics

In 2012, according to the National Center for Health Statistics, assisted living, which includes board and care, was the Number #1 source of long-term care services in the United States with 22,200 paid providers. Overall nearly 59,000 paid care providers served about 8 million residents. In addition to the 22,200 ALs, there are 15,700 nursing homes, 12,200 home care agencies, 4,800 adult day care centers, and 3,700 hospices.

The California HealthCare Foundation found that in 2013 there were 7,455 licensed RCFEs in the State with 145,225 beds. The percentage of these communities by size is:

1-6 beds 80%

7-14 beds 4%

15-49 beds 6%

50-99 beds 5%

100+ 6%

While board and care has the most facilities, assisted living has the capacity to serve twice as many residents. The breakdown for capacity shows:

48% have 100+ beds

24% have 1-6 beds

18% have 50-99 beds

8% have 15-49 beds

2% have 7-14 beds

The monthly rates charged by AL and BC can also differ significantly. The California HealthCare Foundation noted that rates range from $933 per resident per month to $8,445 (with the median at $3,710). Unfortunately their report does not indicate if these rates are for rent and basic services only or whether they also include care. Nor does it provide averages for each type of care.

[This is the second of a two-part series describing a new association in California for small Board and Care owner-operators. See Part 1 here.]

The significant differences between large assisted living communities and 6-bed board and care homes are the number of residents served and the revenues and resources available. This means there are distinctly different operational practices for each.

Operational Differences

California Board and Care Association President, Mylene Lee, says, “Understanding these operational differences – and, therefore, the most helpful kind of support – is what will enable CBCA to best serve its members.

“As an owner-operator of multiple board and care homes for over 12 years, I’ve belonged to several industry associations, but I felt alone and not well-supported. The leadership of those groups did not necessarily own small communities. They wanted quite a bit of money for services I didn’t particularly want. But, all of CBCA’s board are owners, which give us the perspective to really assist and champion our members.”

CBCA Initial Focus

Currently CBCA has 36 members who own 76 board and care homes. They also have 14 associate partners, vendors including home care, hospice, pharmacy, landscapers, etc. Initially, the Association will concentrate on:

Advocacy;

A united focus on improving board and care throughout California;

A coordinated approach to resources and reduced costs through economies of scale; and

Providing support, training, technology and professional development.

Mylene says making sure Association members understand and comply with regulations is a priority. “We want to get as close as possible with our regulators. That’s why our guest speaker at this month’s meeting was the Licensing Program Manager of the Sacramento Regional Office.

“We want greater familiarity with our evaluators so our members won’t be afraid they’ll ‘get in trouble’ just by talking with Licensing. We will keep them up to date on regulations, answer any questions they may have, and even contact Licensing on their behalf,” Mylene states.

CBCA Membership Benefits

Among other benefits of CBCA membership, Mylene lists:

monthly meetings with knowledgeable speakers

breakfast networking meetings

a talent bank of caregiving staff

discounts or special programs from referral agencies

prospect bank and commission-free referrals

information and referrals to affiliated vendors

professional development and training from experts to streamline practices and maximize profits

temporary management so owner/operators can go on vacation

updates and explanations of changes and additions to licensing regulations

tools for compliance

marketing assistance

in-service training of staff

Life Enrichment Activites Program

Also in development is a “life enrichment” activities program – that will include an activities director and, when membership reaches 300, a dedicated bus – to make outings to restaurants, movies and shopping, as well as excursions, more economically feasible.

Mylene believes that at least among the Association’s members, board and care homes serve the highest acuity residents. She says, “We offer seniors lower rates, but can provide better care. A 1 to 3 staffing ratio is common. Also we don’t have to describe our environments as homelike – which is what most seniors want – because our communities actually are homes.

“It’s time,” Mylene concludes, “for owner/operators of board and care homes to be heard, to be recognized, and to be valued. CBCA really understands what board and care operators need and desire so they are able to be the better, smarter, more innovative business owners, licensees, and administrators of this generation.”